Quiz
Chapter 28
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Questions in this quiz (40)
1A patient with mitral stenosis exhibits new symptoms of a dysrhythmia. Based on the pathophysiology of this disease process, the nurse would expect the patient to exhibit what heart rhythm?
- AVentricular fibrillation (VF)
- BVentricular tachycardia (VT)
- CAtrial fibrillation
- DSinus bradycardia
2A patient who has undergone a valve replacement with a mechanical valve prosthesis is due to be discharged home. During discharge teaching, the nurse should discuss the importance of antibiotic prophylaxis prior to which of the following?
- AExposure to immunocompromised individuals
- BFuture hospital admissions
- CDental procedures
- DLive vaccinations
3A patient with hypertrophic cardiomyopathy (HCM) has been admitted to the medical unit. During the nurse’s admission interview, the patient states that she takes over-the-counter water pills on a regular basis. How should the nurse best respond to the fact that the patient has been taking diuretics?
- AEncourage the patient to drink at least 2 liters of fluid daily.
- BIncrease the patient’s oral sodium intake.
- CInform the care provider because diuretics are contraindicated.
- DEnsure that the patient’s fluid balance is monitored vigilantly.
4The critical care nurse is caring for a patient who is receiving cyclosporine postoperative heart transplant. The patient asks the nurse to remind him what this medication is for. How should the nurse best respond?
- AAzathioprine decreases the risk of thrombus formation.
- BAzathioprine ensures adequate cardiac output.
- CAzathioprine increases the number of white blood cells.
- DAzathioprine minimizes rejection of the transplant.
5A patient with a history rheumatic heart disease knows that she is at risk for bacterial endocarditis when undergoing invasive procedures. Prior to a scheduled cystoscopy, the nurse should ensure that the patient knows the importance of taking which of the following drugs?
- AEnoxaparin (Lovenox)
- BMetoprolol (Lopressor)
- CAzathioprine (Imuran)
- DAmoxicillin (Amoxil)
6A patient with pericarditis has just been admitted to the CCU. The nurse planning the patient’s care should prioritize what nursing diagnosis?
- AAnxiety related to pericarditis
- BAcute pain related to pericarditis
- CIneffective tissue perfusion related to pericarditis
- DIneffective breathing pattern related to pericarditis
7A patient newly admitted to the telemetry unit is experiencing progressive fatigue, hemoptysis, and dyspnea. Diagnostic testing has revealed that these signs and symptoms are attributable to pulmonary venous hypertension. What valvular disorder should the nurse anticipate being diagnosed in this patient?
- AAortic regurgitation
- BMitral stenosis
- CMitral valve prolapse
- DAortic stenosis
8The nurse is caring for a patient with mitral stenosis who is scheduled for a balloon valvuloplasty. The patient tells the nurse that he is unsure why the surgeon did not opt to replace his damaged valve rather than repairing it. What is an advantage of valvuloplasty that the nurse should cite?
- AThe procedure can be performed on an outpatient basis in a physician’s office.
- BRepaired valves tend to function longer than replaced valves.
- CThe procedure is not associated with a risk for infection.
- DLower doses of antirejection drugs are required than with valve replacement.
9The nurse is reviewing the echocardiography results of a patient who has just been diagnosed with dilated cardiomyopathy (DCM). What changes in heart structure characterize DCM?
- ADilated ventricles with atrophy of the ventricles
- BDilated ventricles without hypertrophy of the ventricles
- CDilation and hypertrophy of all four heart chambers
- DDilation of the atria and hypertrophy of the ventricles
10A patient has been admitted to the medical unit with signs and symptoms suggestive of endocarditis. The physician’s choice of antibiotics would be primarily based on what diagnostic test?
- AEchocardiography
- BBlood cultures
- CCardiac aspiration
- DComplete blood count
11A community health nurse is presenting an educational event and is addressing several health problems, including rheumatic heart disease. What should the nurse describe as the most effective way to prevent rheumatic heart disease?
- ARecognizing and promptly treating streptococcal infections
- BProphylactic use of calcium channel blockers in high-risk populations
- CAdhering closely to the recommended child immunization schedule
- DSmoking cessation
12A patient with mitral valve prolapse is admitted for a scheduled bronchoscopy to investigate recent hemoptysis. The physician has ordered gentamicin to be taken before the procedure. What is the rationale for this?
- ATo prevent bacterial endocarditis
- BTo prevent hospital-acquired pneumonia
- CTo minimize the need for antibiotic use during the procedure
- DTo decrease the need for surgical asepsis
13The nurse is admitting a patient with complaints of dyspnea on exertion and fatigue. The patient’s ECG shows dysrhythmias that are sometimes associated with left ventricular hypertrophy. What diagnostic tool would be most helpful in diagnosing cardiomyopathy?
- ACardiac catheterization
- BArterial blood gases
- CEchocardiogram
- DExercise stress test
14The nurse is preparing a patient for cardiac surgery. During the procedure, the patient’s heart will be removed and a donor heart implanted at the vena cava and pulmonary veins. What procedure will this patient undergo?
- AOrthotopic transplant
- BXenograft
- CHeterotropic transplant
- DHomograft
15A patient is undergoing diagnostic testing for mitral stenosis. What statement by the patient during the nurse’s interview is most suggestive of this valvular disorder?
- AI get chest pain from time to time, but it usually resolves when I rest.
- BSometimes when I’m resting, I can feel my heart skip a beat.
- CWhenever I do any form of exercise I get terribly short of breath.
- DMy feet and ankles have gotten terribly puffy the last few weeks.
16The nurse is caring for a patient who is scheduled to undergo mechanical valve replacement. Patient education should include which of the following?
- AUse of patient-controlled analgesia
- BLong-term anticoagulant therapy
- CSteroid therapy
- DUse of IV diuretics
17The staff educator is presenting a workshop on valvular disorders. When discussing the pathophysiology of aortic regurgitation the educator points out the need to emphasize that aortic regurgitation causes what?
- ACardiac tamponade
- BLeft ventricular hypertrophy
- CRight-sided heart failure
- DVentricular insufficiency
18The nurse is creating a plan of care for a patient with a cardiomyopathy. What priority goal should underlie most of the assessments and interventions that are selected for this patient?
- AAbsence of complications
- BAdherence to the self-care program
- CImproved cardiac output
- DIncreased activity tolerance
19An older adult patient has been diagnosed with aortic regurgitation. What change in blood flow should the nurse expect to see on this patient’s echocardiogram?
- ABlood to flow back from the aorta to the left ventricle
- BObstruction of blood flow from the left ventricle
- CBlood to flow back from the left atrium to the left ventricle
- DObstruction of blood from the left atrium to left ventricle
20A patient who has undergone valve replacement surgery is being prepared for discharge home. Because the patient will be discharged with a prescription for warfarin (Coumadin), the nurse should educate the patient about which of the following?
- AThe need for regularly scheduled testing of the patient’s International Normalized Ratio (INR)
- BThe need to learn to sleep in a semi-Fowler’s position for the first 6 to 8 weeks to prevent emboli
- CThe need to avoid foods that contain vitamin K
- DThe need to take enteric-coated ASA on a daily basis
21A nurse is planning discharge health education for a patient who will soon undergo placement of a mechanical valve prosthesis. What aspect of health education should the nurse prioritize in anticipation of discharge?
- AThe need for long-term antibiotics
- BThe need for 7 to 10 days of bed rest
- CStrategies for preventing atherosclerosis
- DStrategies for infection prevention
22A patient with mitral valve stenosis is receiving health education at an outpatient clinic. To minimize the patient’s symptoms, the nurse should teach the patient to do which of the following?
- AEat a high-protein, low-carbohydrate diet.
- BAvoid activities that cause an increased heart rate.
- CAvoid large crowds and public events.
- DPerform deep breathing and coughing exercises.
23A patient is admitted to the critical care unit (CCU) with a diagnosis of cardiomyopathy. When reviewing the patient’s most recent laboratory results, the nurse should prioritize assessment of which of the following?
- ASodium
- BAST, ALT, and bilirubin
- CWhite blood cell differential
- DBUN
24A patient has been admitted with an aortic valve stenosis and has been scheduled for a balloon valvuloplasty in the cardiac catheterization lab later today. During the admission assessment, the patient tells the nurse he has thoracolumbar scoliosis and is concerned about lying down for any extended period of time. What is a priority action for the nurse?
- AArrange for an alternative bed.
- BMeasure the degree of the curvature.
- CNotify the surgeon immediately.
- DNote the scoliosis on the intake assessment.
25A patient is a candidate for percutaneous balloon valvuloplasty, but is concerned about how this procedure will affect her busy work schedule. What guidance should the nurse provide to the patient?
- APatients generally stay in the hospital for 6 to 8 days.
- BPatients are kept in the hospital until they are independent with all aspects of their care.
- CPatients need to stay in the hospital until they regain normal heart function for their age.
- DPatients usually remain at the hospital for 24 to 48 hours.
26A patient has been diagnosed with a valvular disorder. The patient tells the nurse that he has read about numerous treatment options, including valvuloplasty. What should the nurse teach the patient about valvuloplasty?
- AFor some patients, valvuloplasty can be done in a cardiac catheterization laboratory.
- BValvuloplasty is a dangerous procedure, but it has excellent potential if it goes well.
- CValvuloplasty is open heart surgery, but this is very safe these days and normally requires only an overnight hospital stay.
- DIt’s prudent to get a second opinion before deciding to have valvuloplasty.
27* The patient has just returned to the floor after balloon valvuloplasty of the aortic valve and the nurse is planning appropriate assessments. The nurse should know that complications following this procedure include what? Select all that apply.
- AEmboli
- BMitral valve damage
- CVentricular dysrhythmia
- DAtrial-septal defect
- EPlaque formation
28The nurse is caring for a patient with right ventricular hypertrophy and consequently decreased right ventricular function. What valvular disorder may have contributed to this patient’s diagnosis?
- AMitral valve regurgitation
- BAortic stenosis
- CAortic regurgitation
- DMitral valve stenosis
29The cardiac nurse is caring for a patient who has been diagnosed with dilated cardiomyopathy (DCM). Echocardiography is likely to reveal what pathophysiological finding?
- ADecreased ejection fraction
- BDecreased heart rate
- CVentricular hypertrophy
- DMitral valve regurgitation
30A 17-year-old boy is being treated in the ICU after going into cardiac arrest during a football practice. Diagnostic testing reveals cardiomyopathy as the cause of the arrest. What type of cardiomyopathy is particularly common among young people who appear otherwise healthy?
- ADilated cardiomyopathy (DCM).
- BArrhythmogenic right ventricular cardiomyopathy (ARVC)
- CHypertrophic cardiomyopathy (HCM)
- DRestrictive or constrictive cardiomyopathy (RCM)
31The nurse is teaching a patient diagnosed with aortic stenosis appropriate strategies for attempting to relieve the symptom of angina without drugs. What should the nurse teach the patient?
- ATo eat a small meal before taking nitroglycerin
- BTo drink a glass of milk before taking nitroglycerin
- CTo engage in 15 minutes of light exercise before taking nitroglycerin
- DTo rest and relax before taking nitroglycerin
32A patient has been living with dilated cardiomyopathy for several years but has experienced worsening symptoms despite aggressive medical management. The nurse should anticipate what potential treatment?
- AHeart transplantation
- BBalloon valvuloplasty
- CCardiac catheterization
- DStent placement
33A patient has undergone a successful heart transplant and has been discharged home with a medication regimen that includes cyclosporine and tacrolimus. In light of this patient’s medication regimen, what nursing diagnosis should be prioritized?
- ARisk for injury
- BRisk for infection
- CRisk for peripheral neurovascular dysfunction
- DRisk for unstable blood glucose
34The nurse is caring for a patient with acute pericarditis. What nursing management should be instituted to minimize complications?
- AThe nurse keeps the patient isolated to prevent nosocomial infections.
- BThe nurse encourages coughing and deep breathing.
- CThe nurse helps the patient with activities until the pain and fever subside.
- DThe nurse encourages increased fluid intake until the infection resolves.
35A patient who has recently recovered from a systemic viral infection is undergoing diagnostic testing for myocarditis. Which of the nurse’s assessment findings is most consistent with myocarditis?
- ASudden changes in level of consciousness (LOC)
- BPeripheral edema and pulmonary edema
- CPleuritic chest pain
- DFlulike symptoms
36The nurse on the hospital’s infection control committee is looking into two cases of hospital-acquired infective endocarditis among a specific classification of patients. What classification of patients would be at greatest risk for hospital-acquired endocarditis?
- AHemodialysis patients
- BPatients on immunoglobulins
- CPatients who undergo intermittent urinary catheterization
- DChildren under the age of 12
37The nurse is caring for a recent immigrant who has been diagnosed with mitral valve regurgitation. The nurse should know that in developing countries the most common cause of mitral valve regurgitation is what?
- AA decrease in gamma globulins
- BAn insect bite
- CRheumatic heart disease and its sequelae
- DSepsis and its sequelae
38Most individuals who have mitral valve prolapse never have any symptoms, although this is not the case for every patient. What symptoms might a patient have with mitral valve prolapse? Select all that apply.
- AAnxiety
- BFatigue
- CShoulder pain
- DTachypnea
- EPalpitations
39A cardiac surgery patient’s new onset of signs and symptoms is suggestive of cardiac tamponade. As a member of the interdisciplinary team, what is the nurse’s most appropriate action?
- APrepare to assist with pericardiocentesis.
- BReposition the patient into a prone position.
- CAdminister a dose of metoprolol.
- DAdminister a bolus of normal saline.
40The nurse is auscultating the breath sounds of a patient with pericarditis. What finding is most consistent with this diagnosis?
- AWheezes
- BFriction rub
- CFine crackles
- DCoarse crackles
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- Nursing (Cardiac) Quiz on Chapter 28, created by Jessica Levine on 06/10/2016.
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- Jessica Levine
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